Individual
DR. ROBERT REX DIETZ
Active
Individual
DR. ROBERT REX DIETZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Taxonomy
Speciality
Code
Description
License number
State
2085N0700X
Neuroradiology Physician
7277
MT
2085R0202X
Diagnostic Radiology Physician
Primary
7277
MT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
101253300
—
WY
01
—
6031
BLUE CROSS BLUE SHIELD
MT
05
—
99125
—
MT
Enumeration date
06/23/2006
Last updated
07/16/2013
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